Abstract

Background

Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking.

Objective

To explore perspectives of stakeholders in the SRP on bridging the gap between desired process scope, and actual practice, from a multi-professional, multi-organizational, and interdisciplinary approach.

Design and setting

Focus group interviews were conducted with various SRP frontline professionals in Region Västra Götaland, Sweden, using purposive sampling to capture a range of experiences. Participants discussed their perceptions of critical changes and priorities needed to meet patients’ SRP needs in a primary care context. All interviews were analyzed using systematic text condensation, as described by Malterud.

Subjects

General practitioners (n = 6), rehabilitation coordinators and licensed healthcare professionals from primary healthcare (n = 13), administrators from the Social Insurance Agency, the Employment Agency and Social Services (n = 12).

Results

Through data analysis, the following themes emerged: 1) The need for rules and regulations to enable coherent process governance 2) Challenges and opportunities in person-centered SRP: Professional collaboration, organizational priorities, and the need for enhanced leadership, and 3) Balancing resources and patient needs in the SRP: How to improve care quality and accessibility. In summary, participants mainly discussed how to improve process efficiency and quality of care while balancing available resources and a heavy workload. A main goal was to prevent negative spirals of suboptimal decision-making in individual cases, which could lead to increased work, unfortunate outcomes, and patient suffering.

Conclusions

This qualitative study indicated that gaps between a desired process scope and actual practice might be bridged by enabling coherent cross-organizational process governance, prioritizing person-centered ways of working, and balancing available resources and workload. The above changes were believed to improve process quality and overall efficiency.

Trial registration

The study project plan was pre-registered on September 21st, 2020, in the database FOU i VGR (researchweb.org), project number 274941.

Details

Title
A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
Author
Löfgren, Märit 1   VIAFID ORCID Logo  ; Törnbom, Karin 2   VIAFID ORCID Logo  ; Gyllenhammar, Daniel 3   VIAFID ORCID Logo  ; Nordeman, Lena 4   VIAFID ORCID Logo  ; Rembeck, Gun 1   VIAFID ORCID Logo  ; Björkelund, Cecilia 5   VIAFID ORCID Logo  ; Svenningsson, Irene 6   VIAFID ORCID Logo  ; Hange, Dominique 7   VIAFID ORCID Logo 

1  General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Södra Älvsborg, Sweden 
2  General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Social Work, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg Sahlgrenska Academy, Gothenburg, Sweden 
3  Department of Technology Management and Economics, Centre of Healthcare Improvements, Chalmers University of Technology, Gothenburg, Sweden 
4  Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Södra Älvsborg, Sweden; Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Unit of Physiotherapy, University of Gothenburg Sahlgrenska Akademin, Gothenburg, Sweden 
5  General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Göteborg, Sweden 
6  General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Fyrbodal, Sweden 
7  General Practice / Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Göteborg, Sweden; Region Västra Götaland, Research, Education, Development & Innovation Primary Health Care, Research, Education, Development & Innovation Center Skaraborg, Sweden 
Pages
324-337
Publication year
2025
Publication date
Jun 2025
Publisher
Taylor & Francis LLC
ISSN
02813432
e-ISSN
15027724
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1080/02813432.2024.2434123
ProQuest document ID
3206351666
Copyright
© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.